胎盘植入性疾病的围产期管理

Perinatal management of placental implantation diseases

胎盘植入性疾病(PAS)已经成为产后出血和围产期子宫切除的主要原因。胎盘植入手术风险大,做好高危患者PAS的排查和诊断,对重度PAS患者及时转诊,选择合适的手术时机,组建多学科团队,做好可靠的术前评估和充分的术前准备,制定合理的手术方案和抢救预案,并由有经验的医生实施手术,从而将风险降至最低。对患者临床诊治的规范化管理,将有助于改善妊娠结局,降低子宫切除率,减少孕产妇严重并发症率和死亡率。

Placental implantation disorders(PAS)have become the main cause of postpartum hemorrhage and perinatal hysterectomy.The risk of placental implantation surgery is high.It is important to conduct screening and diagnosis of high-risk patients with PAS,promptly refer patients with severe PAS,choose appropriate surgical opportunities,form a multidisciplinary team,conduct reliable preoperative evaluation and sufficient preoperative preparation,develop reasonable surgical plans and rescue plans,and have experienced doctors perform the surgery to minimize the risk.Standardized management of clinical diagnosis and treatment for patients will help improve pregnancy outcomes,reduce hysterectomy rates,and reduce severe complications and mortality rates in pregnant and postpartum women.